Evidence map›Paper›PMID 28726183›Full record

SynthesisEndocrine2017

Escalated-dose somatostatin analogues for antiproliferative effect in GEPNETS: a systematic review.

David L Chan, Diego Ferone, Manuela Albertelli, Nick Pavlakis, Eva Segelov, Simron Singh

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Endocrine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
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  4. Article
  5. Review
  6. Review
  7. Article
  8. Review
  9. Article
  10. Review
  11. Article
  12. Review
  13. Article
  14. Review
  15. Review
  16. Drug Development in Neuroendocrine Tumors: What Is on the Horizon?Current treatment options in oncology · 2021
    Review
  17. Review
  18. Medical Management of Gastroenteropancreatic Neuroendocrine Tumors.Surgical oncology clinics of North America · 2020
    Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

David L ChanMedical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Diego FeroneEndocrinology, Department of Internal Medicine and Medical Specialties, IRCCS AOU San Martino-IST, Center of Excellence for Biomedical Research, University of Genova, Genova, Italy.
Manuela AlbertelliEndocrinology, Department of Internal Medicine and Medical Specialties, IRCCS AOU San Martino-IST, Center of Excellence for Biomedical Research, University of Genova, Genova, Italy.
Nick PavlakisMedical Oncology, Royal North Shore Hospital, Sydney, NSW, Australia.
Eva SegelovMedical Oncology, Monash Health and Monash University, Caulfield East, VIC, Australia.
Simron SinghMedical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. simron.singh@sunnybrook.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background/purposeSomatostatin analogues are the cornerstone of systemic therapy for metastatic well-differentiated gastroenteropancreatic neuroendocrine tumours for both hormonal control and antiproliferative effect. Dose escalation of somatostatin analogues is often utilized in clinical practice, but small studies have yielded mixed results. The aim of this study was to systematically determine the efficacy and safety of escalated-dose somatostatin analogues in the above setting.

methodsEligible trials (using more than 30 mg octreotide or 120 mg lanreotide/28 days) were identified from MEDLINE, EMBASE, other databases and conference proceedings. Demographics, disease control rate, objective response rate, biochemical response, improvement in symptoms and toxicity were abstracted. Trials were synthesized qualitatively.

resultsEighteen studies (1002 patients) were identified. The risk of bias was moderate for objective response outcomes, but high for the outcomes of symptom control and toxicity due to open-label trial designs. Disease control rates ranged from 30 to 100%, but response rates were modest (at 0-14%). Rates of biochemical improvement (27-100%) and symptom improvement (23-100%) ranged widely depending on the population studied and the definition of response. The most common toxicities were fatigue, diarrhoea, abdominal discomfort and cholelithiasis, with no severe or unexpected toxicities compared to standard-dose somatostatin analogues.

conclusionsThe current evidence indicates that escalated-dose somatostatin analogues are well-tolerated in patients with gastroenteropancreatic neuroendocrine tumours, with significant rates of disease control but low rates of tumour response. It was difficult to judge the exact rate of biochemical response or symptomatic improvement. There is a need for large, prospective studies investigating the role of escalated-dose somatostatin analogues in the treatment of metastatic gastroenteropancreatic neuroendocrine tumours.

Indexed as

Antineoplastic AgentsDose-Response Relationship, DrugHumansIntestinal NeoplasmsNeuroendocrine TumorsOctreotidePancreatic NeoplasmsPeptides, CyclicReproducibility of ResultsSomatostatinStomach NeoplasmsTumor BurdenAntineoplastic AgentslanreotideOctreotidePeptides, CyclicSomatostatinLanreotideNeuroendocrine tumourOctreotideSomatostatinSSASystematic review

Identifiers

PMID28726183

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.